Role of multi-parameter-based cardiac magnetic resonance in the evaluation of patients with coronary heart disease combined with heart failure

Background : Coronary heart disease (CHD) is one of the most common types of cardiovascular disease, and heart failure (HF) is an important factor in its progression. Cardiovascular magnetic resonance (CMR) is essential for the assessment of myocardial motion morphology and functional changes. Methods: The study retrospectively included 145 CHD patients who were classified into CHD (HF+) (n = 91) and CHD (HF–) (n = 54) groups according to whether HF occurred. LV function, myocardial strain and T1 mapping were assessed by CMR. Multivariate linear regression analyses were performed to identify predictors of LV dysfunction, myocardial fibrosis, and LV remodeling. Results : CHD (HF+) group had impaired global strain, with increased native T1, ECV, and LVM index. In CHD (HF+) group, impaired strain was associated with LVM index (all p < 0.05) after adjusting for clinical variables, where native T1 and ECV were affected by log-transformed amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. ROC analysis showed the combination of global circumferential strain (GCS), native T1, and LVM had a higher diagnostic value (AUC = 0.922) than LVEF (AUC = 0.917) and NT-proBNP (AUC = 0.896) for the occurrence of HF in CHD patients. Conclusion : HF has deleterious effects on LV systolic function in patients with CHD. In CHD (HF+) group, LV dysfunction is strongly correlated with the degree of LV remodeling and myocardial fibrosis. The combination of the three is more valuable in diagnosing HF than conventional indicators.